Servicios de atención e información al visitante: Palacio Real de Madrid

Este trabajo de fin de máster pretende mediante una propuesta arquitectónica dar respuesta a algunos problemas, carencias y necesidades del ámbito de actuación. El proyecto se ubica en la esplanada que hay entre la fachada norte del Palacio Real de Madrid y los jardines de Sabatini, un lugar con un gran valor histórico donde la intervención a realizar se antoja muy complicada. El edificio por construir concluye la conexión entre el palacio y los jardines, que actualmente está incompleta, teniendo en cuenta las necesidades de la ciudad de Madrid, que pretende mejorar su conexión con la casa de campo, y las del propio palacio como atractivo turístico. La función de la construcción consiste en un anexo del palacio que alojará servicios para los visitantes, tanto turistas como vecinos de la ciudad que disfrutarán de una oferta cultural más completa que les permita pasar más tiempo en el palacio y los jardines. Tras un elaborado análisis el proyecto se ha diseñado respetando lo preexistente y pretendiendo dialogar con ello. Tomando como base los mismos criterios arquitectónicos del siglo XVIII, pero actualizados al lenguaje del siglo XXI. Procurando que, aunque es inevitable que cualquier intervención arquitectónica destaque esta lo haga de una forma que concuerde con el conjunto sin estridencias. La construcción tiene la vocación de ser un zócalo de ladrillo que con su silueta quebrada mantiene ese carácter defensivo tan notorio del palacio. Sobre esta forma se engarzan tres piezas en metal y vidrio, que alojan el acceso y dos de los usos principales del conjunto, el Salón de Actos y una Sala de exposiciones temporales que se proyectan hacia los jardines. Desde el principio una de las máximas del diseño del proyecto ha sido que las personas que transitan el conjunto sean participes del entorno pudiendo sentir una mayor relación con el palacio y los jardines que en la actualidad, es por esto que la cubierta se configura como una gran plaza abierta a las vistas, los espacios interiores se proyectan hacia el exterior con grandes ventanales y, la línea del edificio y del pavimento se van desvirtuando hasta fundirse con los jardines.Máster Universitario en Arquitectura (M154

La Neolitización del Valle del Ebro: Imagen de un proceso continental.

Siendo el Neolítico uno de los períodos fundamentales en el desarrollo de las sociedades humanas, pretendemos ofrecer una visión de cómo se produjo la difusión, si es que la hubo, de las novedades que esta nueva forma de relación entre el hombre y la naturaleza trajo consigo. Dentro de una contextualización general del fenómeno, nos hemos centrado en un sector que ha jugado un papel fundamental en el proceso de Neolitización de la Península Ibérica como es el Valle del Ebro. De la mano de los yacimientos involucrados en este proceso y de las fechas absolutas obtenidas sobre elementos de vida corta, pretendemos ofrecer una imagen, lo más fiel posible, de como la nueva forma de vida basada en la producción agropecuaria se implantó en este territorio peninsular que tiene al río Ebro como vertebrador principal.The Neolithic being one of the fundamental periods in the development of human societies, we aim to provide a vision of how the diffusion took place – if indeed it did – and the developments that this new relationship between man and nature brought with it. Within a general contextualization of the phenomenon, we have focused on an area that has played a fundamental role in the Neolithization of the Iberian Peninsula, which is the Ebro Valley. Based on deposits recovered from the site and the exact dates obtained from short-lived elements, we seek to provide a picture, as true as possible, of how the new way of life based on agriculture and livestock was established in this peninsular territory that has the Ebro River as its cradle.Grado en Histori

Real-Time Polymerase Chain Reaction in Stool Detects Transmission of Strongyloides stercoralis from an Infected Donor to Solid Organ Transplant Recipients

Solid organ transplant recipients can acquire Strongyloides stercoralis from an infected donor. The diagnosis of S. stercoralis in immunocompromised individuals may be challenging due to a lower sensitivity of available parasitological and serological methods, compared with immunocompetent individuals. Recently, a real-time polymerase chain reaction (RT-PCR) in stool has been developed for S. stercoralis diagnosis. We report two cases of S. stercoralis infection transmitted by a donor to two solid organ transplant recipients, whose stool samples were diagnosed using RT-PCR. This test could play an important role in S. stercoralis diagnosis in immunosuppressed patients, facilitating rapid treatment initiation and reducing the risk of severe strongyloidiasis. Adherence to current recommendations of screening among donors and recipients from endemic areas is also urgently needed

SEOM SOGUG clinical guideline for treatment of kidney cancer (2022)

Diagnosis; Guidelines; Renal cell carcinomaDiagnóstico; Guías; Carcinoma de células renalesDiagnòstic; Guies; Carcinoma de cèl·lules renalsRenal cancer is the seventh most common cancer in men and the tenth in women. The aim of this article is to review the diagnosis, treatment, and follow-up of renal carcinoma accompanied by recommendations with new evidence and treatment algorithms. A new pathologic classification of RCC by the World Health Organization (WHO) was published in 2022 and this classification would be considered a "bridge" to a future molecular classification. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. Adjuvant treatment with pembrolizumab is an option for intermediate-or high-risk cases, as well as patients after complete resection of metastatic disease. More data are needed in the future, including positive overall survival data. Clinical prognostic classification, preferably IMDC, should be used for treatment decision making in mRCC. Cytoreductive nephrectomy should not be deemed mandatory in individuals with intermediate-poor IMDC/MSKCC risk who require systemic therapy. Metastasectomy can be contemplated in selected subjects with a limited number of metastases or long metachronous disease-free interval. For the population of patients with metastatic ccRCC as a whole, the combination of pembrolizumab-axitinib, nivolumab-cabozantinib, or pembrolizumab-lenvatinib can be considered as the first option based on the benefit obtained in OS versus sunitinib. In cases that have an intermediate IMDC and poor prognosis, the combination of ipilimumab and nivolumab has demonstrated superior OS compared to sunitinib. As for individuals with advanced RCC previously treated with one or two antiangiogenic tyrosine-kinase inhibitors, nivolumab and cabozantinib are the options of choice. When there is progression following initial immunotherapy-based treatment, we recommend treatment with an antiangiogenic tyrosine-kinase inhibitor. While no clear sequence can be advocated, medical oncologists and patients should be aware of the recent advances and new strategies that improve survival and quality of life in the setting of metastatic RC

A predictive model and risk factors for case fatality of covid-19

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February–June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU–death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19

Impact of femtosecond laser-assisted in situ keratomileusis on retinal ganglion cell function

Purpose: To analyse the effect of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) on the electrical response of retinal ganglion cells using pattern electroretinography (pERG). Methods: This was a longitudinal, prospective, observational pilot study. We included consecutive myopic patients who underwent FS-LASIK to correct up to 6dioptres of myopia and up to 2dioptres of astigmatism. Patients with excessive blinking or tearing and those with Snellen uncorrected visual acuity less than 0.9 dec on postop day 1 were excluded. Diopsys NOVA® (Diopsys Inc., NJ) pERG records, using high- and low-contrast patterns, were obtained 16 h and 1month after FS-LASIK was performed. Magnitude (μV), Magnitude D (μV), Magnitude D/Magnitude ratio and signal-to-noise ratio (dB) were analysed. Wilcoxon test for nonparametric paired data was employed. Results: pERG data from 24 eyes were analysed from 24 patients who underwent FS-LASIK. Mean age was 35.79±9.86 years. Mean preoperative refraction was −2.69±7.6D (spherical) and −0.38±0.40D (cylinder). Mean surgical time was 56.88±7.6s. No statistically significant differences were obtained for any of the studied parameters when comparing 16h with 1month after FS-LASIK, with the exception of Magnitude with low contrast, which increased from 1.21±0.2 to 1.39±0.29µV at 16 h and 1month postoperatively, respectively (p=0.03). Conclusions: FS-LASIK seems to induce a mild and transitory defect in retinal ganglion cell function. Only a mild decrease was detected in the magnitude value for low-contrast stimuli when pERG was performed 16h postoperatively, and it returned to normal 1 month after surgery

Current Status of Legislation on Dietary Products for Sportspeople in a European Framework

The consumption of nutritional ergogenic aids is conditioned by laws/regulations, but standards/regulations vary between countries. The aim of this review is to explore legislative documents that regulate the use of nutritional ergogenic aids intended for sportspeople in a Spanish/European framework. A narrative review has been developed from official websites of Spanish (Spanish Agency of the Consumer, Food Safety, and Nutrition) and European (European Commission and European Food Safety Authority) bodies. A descriptive analysis of documents was performed. Eighteen legislative documents have been compiled in three sections: (1) Advertising of any type of food and/or product; (2) Composition, labeling, and advertising of foods; (3) Nutritional ergogenic aids. In spite of the existence of these legal documents, the regulation lacks guidance on the use/application of nutritional ergogenic aids for sportspeople. It is essential to prevent the introduction or dissemination of false, ambiguous, or inexact information and contents that induce an error in the receivers of the information. In this field, it is worth highlighting the roles of the European Food Safety Authority and the World Anti-Doping Agency, which provide information about consumer guidelines, prescribing practices, and recommendations for the prudent use of nutritional ergogenic aids.This work has been partially funded by the “Fundación Séneca de la Región de Murcia” Grupo de Excelencia 19900/GERM/15

Semi‐quantification of binary saline solutions by Raman spectroscopy: Implications for Europa

Producción CientíficaThe Europa lander is a concept for a potential future planetary exploration mission which purpose is to characterize the icy shell of Europa and to search for organics. To achieve this objective, the current concept of the lander includes a Raman spectrometer, such as RLS instrument, that could be able to analyze (sub) surface targets in their solid and liquid form. Knowing that ice and brines of Europa are potentially enriched by sulfate and chlorides, this work seeks to evaluate if Raman spectroscopy could be used to semi quantify the saline content of water solutions using space-like instrumentation. To do so, MgSO4 and MgCl2 were used to prepare three sets of water solutions. Raman analyses were then performed by the laboratory simulator of the ExoMars Raman Laser Spectrometer (RLS), which has been defined as the threshold system for the Europa Lander. After data analysis, two different semi-quantification approaches were tested, and their results compared. Although univariate calibration curves proved to successfully quantify the content of SO42− and Cl− anions dissolved in mono-analyte water solutions, this strategy provided very poor results when applied to binary saline mixtures. Overcoming this issue, the non-linearity prediction ability of Artificial Neural Networks (ANNs) in combination with bandfitting allows to successfully resolve the complexity of the vibrational perturbation suffered by the OH region, which is caused by the cross interaction of H2O molecules with different anions.Ministerio de Economía y Competitividad, Grant/Award Number: PID2019-107442RBC31